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Predictors of Disease-Free and Overall Survival in Retroperitoneal Sarcomas: A Modern 16-Year Multi-Institutional Study from the United States Sarcoma Collaboration (USSC). Sarcoma 2019;2019:5395131

Date

07/10/2019

Pubmed ID

31281208

Pubmed Central ID

PMC6589263

DOI

10.1155/2019/5395131

Scopus ID

2-s2.0-85067822528

Abstract

Background: Retroperitoneal sarcomas (RPS) comprise approximately 15% of all soft-tissue sarcomas and frequently associated with significant morbidity and as little as 30% 5-year survival. Here, we provide a large, contemporary, and multi-institutional experience to determine which tumor, patient, and treatment characteristics are associated with long-term outcomes in RPS.

Methods: 571 patients with primary RPS were identified from the United States Sarcoma Collaboration (USSC). RPS patients who underwent resection from January 2000 to April 2016 were included with patient, tumor, and treatment-specific variables investigated as independent predictors of survival. Survival analyses for disease-free and overall survival were conducted using Kaplan-Meier and Cox proportional hazards model methods.

Results: The study cohort was 55% female, with a median age of 58.9 years (IQR: 48.6-70.0). The most common tumor histiotypes were liposarcoma (34%) and leiomyosarcoma (28%). Median follow-up was 30.6 months (IQR: 11.2-60.4). Median disease-free survival was 35.3 months (95% CI: 27.6-43.0), with multivariate predictors of poorer disease-free survival including higher grade tumors, nodal-positive disease, and multivisceral resection. Median overall survival was 81.6 months (95% CI: 66.3-96.8). Multivariate predictors of shorter overall survival included higher grade tumors, nodal-positive and multifocal disease, systemic chemotherapy, and grossly positive margins (2) following resection.

Conclusions: The strongest predictors of disease-free and overall survival are tumor-specific characteristics, while surgical factors are less impactful. Nonsurgical therapies are not associated with improved outcomes despite persistent interest and utilization. Complete macroscopic resection (0/1) remains a persistent potentially modifiable risk factor associated with improved overall survival in patients with retroperitoneal sarcomas.

Author List

Schwartz PB, Vande Walle K, Winslow ER, Ethun CG, Tran TB, Poultsides G, Tseng J, Roggin K, Grignol V, Howard JH, Krasnick BA, Fields RC, Mogal H, Clarke CN, Senehi R, Votanopoulos K, Cardona K, Abbott DE

Authors

Callisia N. Clarke MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Harveshp Mogal MD Assistant Professor in the Surgery department at Medical College of Wisconsin




jenkins-FCD Prod-399 190a069c593fb5498b7fcd942f44b7bc9cdc7ea1